AB0238 USEFULNESS OF RAPID3 IN ASSESSING UNMET NEEDS OF RHEUMATOID ARTHRITIS PATIENTS FROM THE T-FLAG STUDY
Authors: M. Suzuki, N. Takahashi, Y. Sobue, Y. Ohashi, R. Sato, M. Maeda, D. Kihira, K. Kishimoto, K. Terabe, S. Asai, S. Imagama
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Routine Assessment of Patient Index Data 3 (RAPID3) is a patient-reported outcome (PRO) that can be used to assess the condition of rheumatoid arthritis (RA) patients using only a questionnaire that can be completed in a short time. It is useful as a simple method for assessing disease activity. In previous reports, RAPID3 could be used as an assessment similar to Disease Activity Score 28 (DAS28), a common disease activity assessment [1]. However, in the treatment of RA, there are unmet needs in which patients have low satisfaction with treatment, even though they are in remission according to disease activity assessments such as DAS28. To investigate the cause of this discrepancy, we decided to conduct a study using RAPID3 as a subjective patient assessment and DAS28 as a general disease activity measure. <h3>Objectives</h3> The purpose of this study was to investigate the association between disease activity and RAPID3 in RA patients. <h3>Methods</h3> The data for this study were obtained from the Tsurumai-Frailty and Locomotive Syndrome of Rheumatoid Arthritis for Globalization (T-FLAG), a observational study involving three centers. A PRO questionnaire was administered to 467 RA patients between June 1 and August 31, 2020. Disease activity was assessed using the RAPID3, DAS28-CRP, DAS28-ESR, Clinical Disease Activity Index (CDAI), and Simplified disease activity index (SDAI). the RAPID3 (30 points total) consists of three domains: physical function (0-10), pain (Visual Analogue Scale 0-10), and Patient global assessment (PtGA) of disease activity (0-10). It consists of three domains, divided into disease activity categories (remission: ≤3, low disease activity: 3.1-6, moderate disease activity: 6.1-12, high disease activity: &gt;12). PRO assessment was performed using PtGA, Health Assessment Questionnaire Disability Index (HAQ-DI), Kihon checklist (KCL), and the 25-question Geriatric Locomotive Function Scale (GLFS-25). We compared the disease activity categories using DAS28-CRP and RAPID3. <h3>Results</h3> The mean age (± standard deviation) was 66±13, female was 73%, disease duration was 11±10, RAPID3 was 5.6±5.7, DAS28-CRP was 2.19±1.03, HAQ-DI was 0.46±0.66, and KCL was 6.6±4.4. RAPID3 and DAS28-CRP showed a strong correlation with a correlation coefficient of 0.743, and CDAI and SDAI as other disease activity assessment methods also showed a strong correlation (CDAI: r=0.883, SDAI: r=0.880). On the other hand, the HAQ-DI and GLFS-25, which are PRO assessments of physical function, showed strong correlations, but the KCL, which includes psycho-social assessments along with physical function assessments, showed a slightly weaker correlation (r=0.507). Morning stiffness was not correlated with RAPID3 (r=0.206). In the disease activity category, 59.5% of patients had RAPID3 and DAS28-CRP in the same category (RAPID3 = DAS28-CRP). In addition, RAPID3 belonged to the worse category than DAS28 in 31.3% of cases (RAPID3 &gt; DAS28-CRP). The group with RAPID3 &gt; DAS28-CRP (31.3%) vs. the group with RAPID3 = DAS28-CRP (59.5%) showed no significant differences in age, gender, and tender/swollen joint count (Table 1). On the other hand, there were significant differences between the two groups in disease duration (14 vs. 11 years), PtGA (36 vs. 14mm), HAQ-DI (0.84 vs. 0.29), KCL (8.5 vs. 5.8), and GLFS-25 (28 vs. 13). <h3>Conclusion</h3> In this study, we showed that the correlation between RAPID3 and disease activity assessment was quite strong. In the disease activity category, approximately 60% of all patients had similar DAS28-CRP and RAPID3. However, the discrepancy between DAS28-CRP and RAPID3 may be caused by physical dysfunction and frailty. Therefore, it is important to achieve clinical remission and improve PRO in RA treatment as an intervention to address unmet needs. <h3>Reference</h3> [1] Singh H, et al. Evaluation of disease activity in rheumatoid arthritis by Routine Assessment of Patient Index Data 3 (RAPID3) and its correlation to Disease Activity Score 28 (DAS28) and Clinical Disease Activity Index (CDAI): an Indian experience. Clin Rheumatol. 2012;31(12):1663-9. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.